WQ0042566_Application (FTSE)_20210525

DocuSign Envelope ID: 784C7AC4-4F314D28-8750-815E66677807
State of North Carolina
nWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: W 0 W 4 75-6( (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Sanford (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State!County ® Municipal
3. Signature authority's name: Paul M. Weeks Jr., PE per 15A NCAC 02T .0106(b)
Title: City En ineer
4. Applicant's mailing address: PO BOX 3729
City: Sanford State: NC Zip: 27331-3729
5. Applicant's contact information:
Phone number: [phone] Email Address: paul.weeksla`�.sanfordne.nety
w
11. PROJECT INFORMATION:
n
Is -
I. Project name: Kendall Creek Apartments
70
2. Application/Project status: ® Proposed (New Permit)
n
❑ Existing Permit/Project•
If modification, provide the existing permit number: WQ00_ ..
0
and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00 O
3. County where project is located: Lee
CD
4. Approximate Coordinates (Decimal Degrees): Latitude: 35..444
Longitude:-79.218-
5. Parcel ID (if applicable): 9631-56-2403-00
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Homer S. Wade License Number: 10771
Firm: Borum Wade and Associates
Mailing address. 621 Eugene Ct. Suite 100
City: Greensboro State: NC Zip: 27401-2711
Phone number: Q36) 275-0471 Email Address: kmarlow cr,borum-wade.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Big Buffalo WWTP Permit Number: NCO024147
Owner Name: City of Sanford
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
L Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00047
Owner Name(s): City of Sanford
❑ Privately -Owned Public Utility
❑ Other
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17
FORM: FTA 04-16 Page 1 of 5

DocuSign Envelope ID: 78OC7AC4-4F31-4D28-875C-815E66677807
V1. GENERAL. REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
[-]Yes []No ®NIA
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FQRM: DEV) been attached?
[:]Yes [:]No ZMA
3. If the Applicant is a Home!Property Owners' Association, has an Operational Agreement {FORM: HOA) been attached?
❑ Yes ❑No ®NrA
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
® Residential Leased ❑ Retail with food preparation/service ❑ Hotel an&or Motels
❑ School 1 preschool i day care ❑ Medical i dental.' veterinary facilities ❑ Swimming Pool iClubhousc
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses i offices.," factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % DomesticfCommercial % Commercial
% industrial (See 15A NCAC 02T .0103(20))
Its there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(fl? ❑ Yes ® No
D If Yes, provide a coo-y-of flow reduction nooroval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114if))
Daily Design Flow •,n
No. of Units
Flow
I or 2 Bedroom Units
240 gal/day
72
17,280 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
17,280 GPD
a See 15A NCAC 02T _01 14(b), (d), (e1(11,rand (eX2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .01 14(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114j shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 17,280 GAD (per 15A NCAC 02T .0114)
Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04- l6 Page 2 of 5

DocuSign Envelope ID: 780C7AC4-4F31-4D28-875C-815E66677807
VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers :
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 376.33 DIP
i+ Section II & 111 of the MDC for Permitting of Gravity Sewers contains information related to design criteria
> Section III contains information related to minimum slopes for gravity sewer(s)
> Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC Pumn Stations[Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .0305fl)Xtt:
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B):
> Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
> Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305 (h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T A305(h)(1)(C):
> It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
r If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

DocuSign Envelope ID: 780C7AC4-4F31-4D28-875C-815E66677807
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(0):
1. Does the project comply with all separations found in ,1 SA NCAC 02T..0305f(j & { } ® Yes [:]No
> 15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below vertical
24 inches
Water mains vertical -water over sewer including in benched trenches
18 inches
Water mains horizontal
10 feet
Reclaimed water lines vertical - reclaimed over sewer
18 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
"Any private or public water supply source, including any wells, WS-I waters of Class I or
Class 1T impounded reservoirs used as a source of drinking water
100 feet
"Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water or tide elevation and wetlands see item IX.2
50 feet
**Any other stream, take, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade vertical
36 inches
I5A NCAC 02T.0305(e1 contains alternatives where separations in 02T.0305(f) cannot be achieved.
> "Stream classifications can be identified using the Division's NC Surface Water Classifications webyaae
> If noncompliance with 02T,0305(o or( , see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ NIA
> See the Division's draft separation requirements for situations where separation cannot be meet
> No variance is required if the alternative design criteria specified is utilized in design and construction
> As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200`' ® Yes ❑ No ❑ NIA
Y This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverag0authorization under a 404 Nationwide or ® Yes ❑ No
individual permits or 401 Water Quality Certifications'?
y Information can be obtained from the 401 & suffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105 r ¢) (additional permits?certifications)? ® Yes ❑ No
Per.15_A NCAC 02T.0105(cit6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 155A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ❑ No ❑ NIA
> If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04- l6 Page 4 of 5

DocuSign Envelope ID: 780C7AC4-4F31-4D28-875C-815E66677807
X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02L the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteriailatest versignJ as applicable?
® Yes ❑ No
If No, complete and submit the VarianceiAlternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the rwiteat is required prior to submittal of the Fast Track Application and supporting documents.
Professional Engineer's Certification:
I, lT Q M F R 5 Ap5— attest that this application for
(Professional Engineer's name from Application Item III.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation. a� ,
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
1,
,5,Z0Zo
Paul M. weeks Jr. P.E. City Engineer
(Signature Authority's name & title from Application Item I.3.)
attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 343-2.3-,B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
DocuSdpned by:
Signature: l )L^_ Date: 4/28/2021
BBC39EB6878"B9 .
FORM: FTA 04-16 Page 5 of 5

Q - A Engineers
Planners
Surveyors
Borum, Wade and Associates, 1'.A.
May 19, 2021
N.C.D.E.Q.
Division of Water Resources
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699
Regarding: Kendall Creek Apartments
Access off of Pendergrass Rd.
Sanford, NC
FTA 04-16 for Gravity Sewer (Public)
Dear Sir or Madam:
NC Dept of Environmental Quality
MAy-�+ 202,
Ralei
gh Region pff�cc
Kendall Creek, LLC proposes to develop the above noted 72 unit apartment complex
(elderly facility). In conjunction with this development, a new public gravity sanitary sewer
line owned by the City of Sanford will be installed. The entrance to this project is located
off the Pendergrass Road in Sanford, North Carolina. The proposed public sanitary
sewer line will tie in to the City of Sanford's existing gravity sanitary sewer line off the
shoulder of existing Pendergrass Rd.
Please find the following attached information for review for processing a Gravity Sewer
Permit for the above mentioned project. Included in this package are the following.
1. One original and one copy of the Fast Track Application.
2. One check for $480 (check# 6927)
3. One original and one copy of the Downstream Sewer Flow Tracking/Acceptance.
4. One original and on color copy USGS Topographic Map and one street level map.
Please call if you have any other questions.
Best Regards,
J athan Wade
621 Fugene Court, Suite 100, Greensboro, NC 27401 2711 * PO Box 21882, Greensboro, NC 27420-1882
Phone [phone] • Fax [phone]
Website: wim.borum nvade.com

Docuftn Envelope ID 691 FD3E6-F0634C7D A0B4-A745F2Twc 10
�Y{!)apt gf'FDvlrohrR�Dt
:<
al Quallty State of North Carolina
MAY Department of Environmental Quality
Rak Division of Water Resources
.�..� V 4 .� � r�,}t keR'nnal 0
,iw Tracking for Sewer Extension Applications
Division of Water Resources (FTSE 10-18)
Application Number: FFF6327
Entity Requesting Allocation: City of Sanford
Project Name for which flow is being requested: Kendall Creek Apts.
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposer! wastewatern'ow.
Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility name: Big Buffalo Wastewater Treatment Plant
b. WWTP Facility Permit #: NCO024147
All flows are in MGD
c.
WWTP facility permitted flow:
12.0000
d.
Estimated obligated flow not yet tributary to the WWTP:
1.0777
e.
WWTP facility's actual average flow:
5.7330
f.
Total flow for this specific request:
0.0173
g.
Total actual and obligated flows to the facility:
6.8280
h.
Percent of Dermitted flow used:
570}0
II. Complete this section for each pump station you are responsible for along the route of this proposed
List pump stations located between the project connection point and the WWTP.
(A)
(B)
(C)
(D) = (B+C)
(E)=(A-D)
Pump
Pump
Firm
Design
Approx.
Obligated,
Total Current
Available
Station
Station
Capacity'
Average
Current
Not Yet
Flow Plus
Capacity
(Name or
Permit
Daily Floww
Avg. Daily
Tributary
Obligated
Number)
Number
rFirm1nn.
Flow,
Daily Flow,
Flow
MGD
MGD
MGD
MGD
MGD
MGD
#N: A
MA
#N/A
#NIA
MIA
#NIA
#NIA
#NIA
#NIA
#NIA
UNIA
#NIA
#NIA
#NIA
#NIA
#NIA
MA
#NIA
MA
#NIA
#NIA
#NIA
#WA
#N1A
HNIA
#WA
#N?A
#N.-A
#NIA
#N,A
#NIA
MIA
#NIA
#NIA
MA
#NfA
#N.,A
#NIA
#WA
#N!A
#NIA
#NIA
1. The Firm Capacity (design now) of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
2. Design Average Flow is the firm capacity of the pump station divided by the peaking factor (pf) not
less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
3. A Planning Assessment Addendum shall be attached for each pump station located between the
project connection point and the WWTP where the Available Capacity is 5 0.
Downstream Facility Name (Sewer): City of Sanford Collection System
Downstream Permit Number: WQCS00047
Page 1 of 6 FTSE 10-18

Dccuftn Envelope In. 691F03ES-POSS 4CyD-AOB4-A745F26FOB10
III. Certification Statement
I, Paul Weeks, Jr. PE, certify to the best of my knowledge that the addition of the volume of
wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any
capacity related sanitary sewer overflows or overburden any downstream pump station en route to the
receiving treatment plant under normal circumstances, given the implementation of the planned
improvements identified in the planning assessment where applicable. This analysis has been
performed in accordance with local established policies and procedures using the best available data.
This certification applies to those items listed above in Sections I and H plus all attached planning
assessment addendums for which I am the responsible party. Signature of this form certifies that the
receiving collection system or treatment works has adequate capacity to transport and treat the
proposed new wastewater.
—e«u"nw w:
pawl, k. Uk w Y. P.e 04WP21
_eRUnpawevM
Signing Official Signature
City Engineer
Title of Signing Official
Date
Page 2 of 6 ME 10-18

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